The Centers for Medicare & Medicaid Services has rejected what has become a standard argument among waiver applicants, that the 80% medical loss ratio requirement would destabilize the state's individual market and cause insurers to withdraw.

Many independent physicians are throwing up their hands about their ability to remain so in an environment that appears to actively discourage it. But while autonomy appears to be the tougher road, it may eventually be the more rewarding one.

More than three-quarters of organizations are exploring or have M&A deals under way, according to this HealthLeaders Media Intelligence Report. Get the free report with exclusive research and analysis.